EHR Data Sharing Challenges Hospitals

RICH DALY, HFM SENIOR WRITER/EDITOR

Aug. 7—Problems sharing digital health data with other providers and with patients have kept the numbers of hospitals successfully attesting to stage 2 of the federal electronic health record incentive program low, new research indicates.

Seventy-eight hospitals have attested to stage 2 of meaningful use for the 2014 reporting year through the start of August, according to data released Monday. That was a jump from the 10 hospitals that had attested through July, but still indicated many hospitals have far to go.

New research indicates that the areas that may be slowing hospitals down the most in attesting to stage 2 of meaningful use are those aspects of the 16 core objectives related to data sharing—both with other providers and patients.

Researchers: Number of Factors Limit Data Sharing

The study, published Thursday in Health Affairs, found that while “the vast majority” of hospitals reported an ability to meet many stage 2 objectives, only 10.4 percent were providing patients with online access to information about an admission. Meeting that objective required three components, for which hospitals demonstrated varying levels of achievement: transmit function, 11.6 percent; download function, 27.5 percent; and view function 39.3 percent.

“There are a couple places were hospitals are starting to get stuck and it is worth understanding those because that is where we have to target our efforts,” Ashish Jha, MD, one of the study’s authors, said at a Thursday health IT discussion in Washington, D.C.

Representatives of the hospital industry told the Health IT Policy Committee in May that the timeline for stage 2 was too aggressive. They said more standardization was needed to allow data exchange, including for interstate data exchange.

Speakers at the health IT event noted a variety of factors could be limiting data sharing, including competitive concerns and technological limitations.

“It’s not surprising that hospitals are struggling with the latest round of meaningful use requirements as they juggle a growing number of quality improvement and cost containment requirements, absorb Medicare cuts and struggle to find vendors with all of the needed capabilities,” said Chad Mulvany, director of healthcare finance policy, strategy and development for HFMA. “The struggles of safety net hospitals, especially, to meet these and many other quality and cost requirements underscored the need to delay stage 2 of meaningful use.”

The study noted that hospital struggles with online access and transmittal of patients’ health information may reflect a lack of EHR system capabilities. The authors wrote that 2014 certified edition products have not yet been widely adopted, and few vendors had these features available in 2013.

“In addition, the implementation of these information exchange functions may be hampered by a lack of information-trading partners that are functionally prepared to receive the data,” the study said about providers that include post-acute care facilities and many physician offices.

EHR Successes Identified

The research also underscored EHR successes, including adoption of at least a basic EHR by 58.9 percent of hospitals and a comprehensive EHR by 25.5 percent. Large, urban, not-for-profit, and major teaching hospitals were more likely to have a basic EHR. Meanwhile, critical access hospitals were no less likely than other hospitals to have adopted a basic EHR but were significantly less likely to have a comprehensive EHR.

The majority of stage 2 requirements on which most hospitals reported good preparedness included at least 90 percent of hospitals being able to use their EHR to record vital signs, smoking status, and patient demographic characteristics; incorporate clinical lab test results as structured data; generate patient lists by specific conditions; provide patient-specific educational resources; and track medications using electronic medication administration records.

“No country has moved this far this fast on EHR adoption—certainly not on the hospital side,” Jha said.

Aug. 7—Problems sharing digital health data with other providers and with patients have kept the numbers of hospitals successfully attesting to stage 2 of the federal electronic health record incentive program low, new research indicates.

Seventy-eight hospitals have attested to stage 2 of meaningful use for the 2014 reporting year through the start of August, according to data released Monday. That was a jump from the 10 hospitals that had attested through July, but still indicated many hospitals have far to go.

New research indicates that the areas that may be slowing hospitals down the most in attesting to stage 2 of meaningful use are those aspects of the 16 core objectives related to data sharing—both with other providers and patients.

Researchers: Number of Factors Limit Data Sharing

The study, published Thursday in Health Affairs, found that while “the vast majority” of hospitals reported an ability to meet many stage 2 objectives, only 10.4 percent were providing patients with online access to information about an admission. Meeting that objective required three components, for which hospitals demonstrated varying levels of achievement: transmit function, 11.6 percent; download function, 27.5 percent; and view function 39.3 percent.

“There are a couple places were hospitals are starting to get stuck and it is worth understanding those because that is where we have to target our efforts,” Ashish Jha, MD, one of the study’s authors, said at a Thursday health IT discussion in Washington, D.C.

Representatives of the hospital industry told the Health IT Policy Committee in May that the timeline for stage 2 was too aggressive. They said more standardization was needed to allow data exchange, including for interstate data exchange.

Speakers at the health IT event noted a variety of factors could be limiting data sharing, including competitive concerns and technological limitations.

“It’s not surprising that hospitals are struggling with the latest round of meaningful use requirements as they juggle a growing number of quality improvement and cost containment requirements, absorb Medicare cuts and struggle to find vendors with all of the needed capabilities,” said Chad Mulvany, director of healthcare finance policy, strategy and development for HFMA. “The struggles of safety net hospitals, especially, to meet these and many other quality and cost requirements underscored the need to delay stage 2 of meaningful use.”

The study noted that hospital struggles with online access and transmittal of patients’ health information may reflect a lack of EHR system capabilities. The authors wrote that 2014 certified edition products have not yet been widely adopted, and few vendors had these features available in 2013.

“In addition, the implementation of these information exchange functions may be hampered by a lack of information-trading partners that are functionally prepared to receive the data,” the study said about providers that include post-acute care facilities and many physician offices.

EHR Successes Identified

The research also underscored EHR successes, including adoption of at least a basic EHR by 58.9 percent of hospitals and a comprehensive EHR by 25.5 percent. Large, urban, not-for-profit, and major teaching hospitals were more likely to have a basic EHR. Meanwhile, critical access hospitals were no less likely than other hospitals to have adopted a basic EHR but were significantly less likely to have a comprehensive EHR.

The majority of stage 2 requirements on which most hospitals reported good preparedness included at least 90 percent of hospitals being able to use their EHR to record vital signs, smoking status, and patient demographic characteristics; incorporate clinical lab test results as structured data; generate patient lists by specific conditions; provide patient-specific educational resources; and track medications using electronic medication administration records.

“No country has moved this far this fast on EHR adoption—certainly not on the hospital side,” Jha said.

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